Individual
CHRISTINE BODE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASTERS DEGREE EDU
Contact information
Practice address
1629 WASHINGTON AVE, BOHEMIA, NY 11716-1424
(631) 563-3247
Mailing address
1629 WASHINGTON AVE, BOHEMIA, NY 11716-1424
(631) 563-3247
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
792510
NY
Other
Enumeration date
07/02/2012
Last updated
07/02/2012
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